US mortality data from 2003 to 2023 shows that COVID-19 deaths may have been overcounted by up to two thirds, according to a study published in June by Nobel laureate in chemistry Michael Levitt and epidemiologist and statistician John Ioannidis, multipolar-magazin.de reported.
Re-Examining 57 Million Death Certificates
Researchers re-examined nearly 57 million death certificates issued across the United States and compared those records with official national mortality statistics to assess how underlying and contributing causes of death were processed over a 21-year period.
Levitt and his co-authors tracked how cause-of-death classifications shifted over time as the International Classification of Diseases (ICD) was updated and new ICD-10 codes were added. The analysis revealed that the ICD codes assigned to primary causes of death changed in roughly one third of all evaluated cases during the study period. About half of those changes involved shifts into entirely different overarching disease categories.
Coding Rules Inflated COVID-19 Mortality Estimates
These reclassifications became more frequent during the COVID-19 pandemic between 2020 and 2021 following the introduction of specific COVID-19 coding rules. The statistical adjustments nearly doubled the number of deaths attributed primarily to the virus. Conversely, when researchers factored in multimorbidities—weighting multiple contributing conditions listed on the death certificates alongside the primary cause—the estimated COVID-19 mortality burden dropped by 44 to 63 percent.
Contrasting Official Tolls With Multicausal Models
The study estimates that COVID-19 was cumulatively responsible for approximately 100,000 deaths among individuals under 65 and about 300,000 deaths among those aged 65 and older in the United States between 2020 and 2023.
Those figures contrast sharply with the roughly 1.17 million total COVID-19 deaths reported by the top US health authority for the same timeframe. The authors argue that relying on a single underlying cause of death is obsolete because most modern deaths involve several interacting health conditions that erode a person’s resilience over time. SARS-CoV-2 infections almost universally occurred alongside severe pre-existing comorbidities, which strongly correlated with fatal outcomes. A similar study published last year regarding hospital deaths in Athens, Greece, similarly concluded that nearly half of recorded COVID-19 patients died with the virus rather than strictly from it.
Unresolved Questions for International Health Agencies
Researchers point out that while countries like Germany separate a primary underlying disease from secondary conditions on death certificates, independent researchers lack public access to the multicausal chains listed in the secondary sections of official records.